Mental Health Concerns Associated With Mothers of Children With Multiple Sclerosis

Mothers who have children with multiple sclerosis (MS) have a higher prevalence of physical conditions, as well as a higher prevalence of mood and anxiety disorders before, during, and after their child’s MS diagnosis when compared with mothers of children without MS, a study in Neurology reports.

Investigators from the Canadian Pediatric Demyelinating Disease Network performed a population-based, retrospective analysis of administrative data from Ontario, Canada. Using this database, the researchers identified mothers of children with MS (n=156) and mothers of children without MS (n=624), all of whom were matched on maternal age at childbirth, region, and the child’s age and sex at time of MS diagnosis.

Prevalence rates of any physical condition (eg, hypertension, diabetes, heart disease, and lung disease) or any mood or anxiety disorder during the child’s MS diagnosis year as well as 5 years before and after diagnosis were compared between the 2 groups. In addition, the rates of physician visits before diagnosis, during the diagnosis year, and after the child’s diagnosis were compared between the mothers of children with MS and mothers of children without MS. Analyses were adjusted for maternal age, socioeconomic status, region of residence, and index year.

At 5 years before the child’s MS diagnosis, mothers of children with MS had significantly higher prevalence rates for any physical condition compared with mothers of children without MS (21.5 [95% CI, 14.6-29.7] vs 19.4 [95% CI, 16.1-23.2], respectively; standardized rate ratio [RR], 1.16, 95% CI, 1.10-1.17; P <.05). Similar findings were reported at 4, 3, and 2 years before MS diagnosis (all, P <.05).

During the diagnosis year, mothers of children with MS had a significantly greater prevalence rate of any physical condition (27.6 [95% CI, 19.9-37.1] vs 27.7 [95% CI, 23.7-32.2]; standardized RR, 1.05; 95% CI, 1.02-1.07; P <.05). Similar findings were reported at 1, 2, 4, and 5 years after diagnosis (all, P <.05).

The prevalence of any mood or anxiety disorder was also significantly higher in mothers of children with MS at 5 years (standardized RR, 1.33; 95% CI, 1.30-1.46; P <.05), 4 years (standardized RR, 0.75; 95% CI, 0.73-0.76; P <.05), 3 years (standardized RR, 1.18; 95% CI, 1.24-1.33; P <.05), 2 years (standardized RR, 0.86; 95% CI, 0.82-0.87; P <.05), and 1 year (standardized RR, 1.07; 95% CI, 1.02-1.12; P <.05) before diagnosis. A significantly higher prevalence of any mood or anxiety disorder was also found for mothers of children with MS during the diagnosis year (standardized RR, 2.20; 95% CI, 2.16-2.25; P <.05). Similar findings were reported at 1, 2, 3, and 5 years after the child’s MS diagnosis (all, P <.05).

Mothers of children with MS did not have higher rates of primary care visits (RR, 1.04; 95% CI, 0.90-1.20); however, these mothers did have increased odds of having any psychiatry visits (odds ratio, 1.60; 95% CI, 1.10-2.31). The rate of psychiatry visits, however, did not differ between the 2 groups (RR, 0.66; 95% CI, 0.33-1.30).

Limitations of this study include the lack of data on each child’s MS characteristics, the inclusion of only data regarding mothers’ health and healthcare use, and the lack of data on healthcare use from nonphysician providers.

As a result of stressors experienced by parents of children with chronic health conditions, parents may have less time to address their own health needs. Nevertheless, parental distress is associated with adverse childhood health outcomes. These findings suggest that “[p]ediatric health care providers should be alert to possible mental health concerns of mothers of children with MS.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

Marrie RA, O’Mahony J, Maxwell C, et al; Canadian Pediatric Demyelinating Disease Network. Increased mental health care use by mothers of children with multiple sclerosis [published online January 9, 2020]. Neurology. doi:10.1212/WNL.0000000000008871